Southwest Memorial Hospital in Cortez recently got new equipment that allows doctors to clearly see into a patient’s throat.
It’s called a fiber-optic evaluation of swallowing, and the hospital has two certified speech language pathologists who administer the test.
A 4 mm tube with a camera on its end goes up into a patient’s nose, through the nasal cavity and into the throat, said Molly Greenlee, a speech language pathologist at Southwest Health System.
The camera is angled down to look into the larynx. What they’re looking for is residue in the throat after swallowing, an indicator the patient is having trouble swallowing, Greenlee said.
Rachel Garrison, a speech language pathologist at the hospital, strongly advocated for the new equipment over several years.
Previously, the only way to see into a patient’s throat was through something called barium swallow, Garrison said. That procedure requires X-rays and exposes patients and the doctor to radiation.
Plus, the image that comes out of it is “gray blobs,” Garrison said.
The new test provides a clear image of the throat, which is necessary to troubleshoot a swallowing problem.
A handful of patients have used the new equipment so far, as they just got it in August. Most report mild discomfort during the test, Garrison said.
“In the range of procedures the hospital has, we are the good guys,” Greenlee said.
To show The Journal how the test works, Staci Cost, a physical therapist at Southwest Health, agreed to be a guinea pig.
Greenlee prepared the equipment and explained what she was going to do, as Garrison placed a small washcloth on Cost’s shoulder.
“What’s this for? My tears?” asked Cost.
“No, it’s for your snot,” Garrison replied.
Greenlee instructed Cost to rub her nostrils and asked which side she was breathing out of better, which side felt better.
“The right one,” Cost said.
And so Greenlee proceeded to stick the camera up her nose.
After a few minutes of searching, Greenlee and Garrison didn’t find what they were looking for – the camera was mostly showing red, and what looked like irritated, tissue.
“I’ve got a deviated septum,” said Cost. “Too many soccer balls to the face.”
Greenlee then removed the tube – Cost later said the removal is the easiest part – and after some deliberation, decided to go into the left nostril.
“This isn’t nearly as uncomfortable as the right,” Cost said.
Garrison and Greenlee quickly found the clear view of the throat they were looking for.
They gave Cost lemon Jell-O, dyed bright green to easily see on the screen, and water to see her swallow. Sometimes the problem people have is aspiration, where food and water enter the airway and ultimately the get into the lungs.
Garrison said when they see a patient who’s staying at the hospital, they tell nutrition services which food is safe for them to eat.
They also prescribe swallow therapy to make muscles in the neck stronger, Greenlee said.
“It’s surprisingly tiring,” Greenlee said.
A common swallow therapy exercise is to stick the tongue out slightly between your teeth and then swallow.
After exploring her left nostril, Greenlee asked Cost to rate the discomfort on a scale from one to 10, 10 being the worst.
“For the left side, one or two,” said Cost. “For the right, four maybe.”
Greenlee said if someone is having trouble swallowing, to contact their doctor and come and get the test done.
